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Acute infectious lymphocytosis

Acute infectious lymphocytosis (lymphocytosis acuta infectiosa; synonym acute asymptomatic lymphocytosis) - benign viral disease mainly children (1 to 14), characterized in normal hyperskeocytosis absence or weakly expressed clinical manifestations.

The disease is ubiquitous. Adults are sick very rarely. Numerous outbreaks in institutions, families and sporadic diseases have been described. Sometimes they are detected by mass hematological examinations. Biopsy and puncture of lymph node lymphocytes detect and lymphoreticular cells.

The incubation period is from 6 to 25-35 days. Most often hidden and erased forms an acute infectious lymphocytosis, which appear randomly when blood studies febrile forms which occasionally accompanied by raising the temperature to 40 ° with a considerable worsening of the overall condition. Severe forms with meningeal and encephalitic symptoms are rare. May experience respiratory catarrh, sore throat, dyspepsia, abdominal pain, mimic appendicitis, skarlatino- and morbilliform rash, arthralgia and myalgia. An enlarged lymph node and spleen is rarely observed. During operations, an increase in the retrohepatic lymph nodes is sometimes found. Total protein remained in the normal range, the albumin level is reduced, globulin level increased due to beta-, gamma- and alpha-globulins partially. All these violations are very short.

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The main determining the diagnosis of a symptom is a change in the white blood - high leukocytosis (30 000 to 140 000). Dominated (80-90%), small lymphocytes with dark pyknotic nucleus uzkoprotoplazmennye. There are lymphocytes medium and even large, atypical lymphocytes, monocyte and lymphoreticular cells, calf Botkin, basket cells. Some lymphocytes are wide protoplasmic with azurophilic granularity. The absolute number of eosinophils increased. The number of leukocytes increases for 4-6 days, kept at a maximum level of 6-10 days, and then no treatment is reduced to normal or below, followed by the rise to the normal level. The duration of the period of pathological changes in the blood 14-30 days.

The differential diagnosis is carried out with respect to chronic lymphocytic leukemia, infectious mononucleosis and toxoplasmosis. The first in children is extremely rare. His is prolonged severe course, an enlarged spleen and lymph nodes, pathology and red blood bone marrow punctate. Infectious mononucleosis is carried out at high temperatures, accompanied by angina, lymphadenitis, particularly cervical and occipital, an enlarged spleen and liver and blood characteristic changes. Limfonodulyarnaya form toxoplasmosis is determined using techniques that identify Toxoplasma, as well as allergic and serological assays.

Treatment is symptomatic. Apply ACTH, cortisone. Prevention is not developed. Some authors advise to isolate patients.